Top

Published in:

18-03-2024 | Acute Respiratory Distress-Syndrome | What's New in Intensive Care

Bedside-available strategies to minimise P-SILI and VILI during ARDS

Authors: Oriol Roca, Irene Telias, Domenico L. Grieco

Published in: Intensive Care Medicine | Issue 4/2024

Excerpt

Ventilator-induced (VILI) and patient-self-induced lung injury (P-SILI) contribute to acute respiratory distress syndrome (ARDS) progression in a relevant proportion of patients. VILI is a well-established concept encompassing all deleterious effects of mechanical ventilation (MV) [1]. It is a consequence of the excessive stress (pressure applied to the lungs) and strain (deformation induced by inflated volume) imposed by MV to the aerated lung. VILI jeopardises patient’s outcome through lung biotrauma, which induces systemic inflammation and may contribute to multiorgan failure, a frequent cause of death in ARDS patients. P-SILI is a more recent concept and includes all the conditions in which spontaneous breathing in ARDS patients exhibiting high inspiratory effort causes the inflation of large tidal volumes (Vt) yielding large transpulmonary pressure (P_L) swings, increases in transvascular pressure favouring hydrostatic pulmonary oedema and regional overinflation through an intra-tidal redistribution of Vt from non-dependent to dependent lung regions (i.e. pendelluft) [2]. …

Slutsky AS, Ranieri VM (2013) Ventilator-induced lung injury. N Engl J Med 369:2126–2136CrossRefPubMed

Brochard L, Slutsky A, Pesenti A (2017) Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med 195:438–442CrossRefPubMed

Grasselli G, Calfee CS, Camporota L, Poole D, Amato MBP, Antonelli M, Arabi YM, Baroncelli F, Beitler JR, Bellani G, Bellingan G, Blackwood B, Bos LDJ, Brochard L, Brodie D, Burns KEA, Combes A, D’Arrigo S, De Backer D, Demoule A, Einav S, Fan E, Ferguson ND, Frat JP, Gattinoni L, Guérin C, Herridge MS, Hodgson C, Hough CL, Jaber S, Juffermans NP, Karagiannidis C, Kesecioglu J, Kwizera A, Laffey JG, Mancebo J, Matthay MA, McAuley DF, Mercat A, Meyer NJ, Moss M, Munshi L, Myatra SN, Ng Gong M, Papazian L, Patel BK, Pellegrini M, Perner A, Pesenti A, Piquilloud L, Qiu H, Ranieri MV, Riviello E, Slutsky AS, Stapleton RD, Summers C, Thompson TB, Valente Barbas CS, Villar J, Ware LB, Weiss B, Zampieri FG, Azoulay E, Cecconi M (2023) ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategies. Intensive Care Med 49(7):727–759CrossRefPubMedPubMedCentral

Grieco DL, Maggiore SM, Roca O, Spinelli E, Patel BK, Thille AW, Barbas CSV, de Acilu MG, Cutuli SL, Bongiovanni F, Amato M, Frat JP, Mauri T, Kress JP, Mancebo J, Antonelli M (2021) Non-invasive ventilatory support and high-flow nasal oxygen as first-line treatment of acute hypoxemic respiratory failure and ARDS. Intensive Care Med 47:851–866CrossRefPubMedPubMedCentral

Tsolaki VS, Zakynthinos GE, Mantzarlis KD, Deskata KV, Papadonta ME, Gerovasileiou ES, Manoulakas EE, Zakynthinos E, Pantazopoulos IN, Makris DA (2021) Driving pressure in COVID-19 acute respiratory distress syndrome is associated with respiratory distress duration before intubation. Am J Respir Crit Care Med 204:478–481CrossRefPubMedPubMedCentral

Tonelli R, Fantini R, Tabbì L, Castaniere I, Pisani L, Pellegrino MR, Della Casa G, D’Amico R, Girardis M, Nava S, Clini EM, Marchioni A (2020) Early inspiratory effort assessment by esophageal manometry predicts noninvasive ventilation outcome in de novo respiratory failure. a pilot study. Am J Respir Crit Care Med 202:558–567CrossRefPubMedPubMedCentral

Rittayamai N, Katsios CM, Beloncle F, Friedrich JO, Mancebo J, Brochard L (2015) Pressure-controlled vs volume-controlled ventilation in acute respiratory failure: a physiology-based narrative and systematic review. Chest 148:34s0-355CrossRef

Camporota L, Rose L, Andrews PL, Nieman GF, Habashi NM (2024) Airway pressure release ventilation for lung protection in acute respiratory distress syndrome: an alternative way to recruit the lungs. Curr Opin Crit Care 30:76–84CrossRefPubMed

Goligher EC, Costa ELV, Yarnell CJ, Brochard LJ, Stewart TE, Tomlinson G, Brower RG, Slutsky AS, Amato MPB (2021) Effect of lowering tidal volume on mortality in ARDS varies with respiratory system elastance. Am J Respir Crit Care Med 203(11):1378–1385CrossRefPubMed

10.

Costa ELV, Slutsky A, Brochard LJ, Brower R, Serpa-Neto A, Cavalcanti AB, Mercat A, Meade M, Morais CCA, Goligher E, Carvalho CRR, Amato MBP (2021) Ventilatory variables and mechanical power in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 204(3):303–311CrossRefPubMed

11.

Gattinoni L, Collino F, Camporota L (2023) Mechanical power: meaning, uses and limitations. Intensive Care Med 49:465–467CrossRefPubMedPubMedCentral

12.

Guérin C, Albert RK, Beitler J, Gattinoni L, Jaber S, Marini JJ, Munshi L, Papazian L, Pesenti A, Vieillard-Baron A, Mancebo J (2020) Prone position in ARDS patients: why, when, how and for whom. Intensive Care Med 46:2385–2396CrossRefPubMedPubMedCentral

13.

Chen L, Del Sorbo L, Grieco DL, Junhasavasdikul D, Rittayamai N, Soliman I, Sklar MC, Rauseo M, Ferguson ND, Fan E, Richard JM, Brochard L (2020) Potential for lung recruitment estimated by the recruitment-to-inflation ratio in acute respiratory distress syndrome. A clinical trial. Am J Respir Crit Care Med 201:178–187CrossRefPubMed

14.

Chiumello D, Arnal JM, Umbrello M, Cammaroto A, Formenti P, Mistraletti G, Bolgiaghi L, Gotti M, Novotni D, Reidt S, Froio S, Coppola S (2020) Hysteresis and lung recruitment in acute respiratory distress syndrome patients: a CT scan study. Crit Care Med 48:1494–1502CrossRefPubMed

15.

Jonkman AH, Alcala GC, Pavlovsky B, Roca O, Spadaro S, Scaramuzzo G, Chen L, Dianti J, Sousa MLA, Sklar MC, Piraino T, Ge H, Chen GQ, Zhou JX, Li J, Goligher EC, Costa E, Mancebo J, Mauri T, Amato M, Brochard LJ (2023) Lung recruitment assessed by electrical impedance tomography (RECRUIT): a multicenter study of COVID-19 acute respiratory distress syndrome. Am J Respir Crit Care Med 208:25–38CrossRefPubMedPubMedCentral

16.

Calfee CS, Delucchi K, Parsons PE, Thompson BT, Ware LB, Matthay MA (2014) Subphenotypes in acute respiratory distress syndrome: latent class analysis of data from two randomised controlled trials. Lancet Respir Med 2:611–620CrossRefPubMedPubMedCentral

17.

Mauri T, Yoshida T, Bellani G, Goligher EC, Carteaux G, Rittayamai N, Mojoli F, Chiumello D, Piquilloud L, Grasso S, Jubran A, Laghi F, Magder S, Pesenti A, Loring S, Gattinoni L, Talmor D, Blanch L, Amato M, Chen L, Brochard L, Mancebo J, Group PLpw (2016) Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives. Intensive Care Med 42:1360–1373CrossRefPubMed

18.

Yoshida T, Amato MBP, Grieco DL, Chen L, Lima CAS, Roldan R, Morais CCA, Gomes S, Costa ELV, Cardoso PFG, Charbonney E, Richard JM, Brochard L, Kavanagh BP (2018) Esophageal manometry and regional transpulmonary pressure in lung injury. Am J Respir Crit Care Med 197:1018–1026CrossRefPubMed

19.

Sarge T, Baedorf-Kassis E, Banner-Goodspeed V, Novack V, Loring SH, Gong MN, Cook D, Talmor D, Beitler JR (2021) Effect of esophageal pressure-guided positive end-expiratory pressure on survival from acute respiratory distress syndrome: a risk-based and mechanistic reanalysis of the EPVent-2 trial. Am J Respir Crit Care Med 204:1153–1163CrossRefPubMedPubMedCentral

20.

Grasso S, Terragni P, Birocco A, Urbino R, Del Sorbo L, Filippini C, Mascia L, Pesenti A, Zangrillo A, Gattinoni L, Ranieri VM (2012) ECMO criteria for influenza A (H1N1)-associated ARDS: role of transpulmonary pressure. Intensive Care Med 38:395–403CrossRefPubMed

21.

Dianti J, Fard S, Wong J, Chan TCY, Del Sorbo L, Fan E, Amato MBP, Granton J, Burry L, Reid WD, Zhang B, Ratano D, Keshavjee S, Slutsky AS, Brochard LJ, Ferguson ND, Goligher EC (2022) Strategies for lung- and diaphragm-protective ventilation in acute hypoxemic respiratory failure: a physiological trial. Crit Care 26:259CrossRefPubMedPubMedCentral

22.

Telias I, Junhasavasdikul D, Rittayamai N, Piquilloud L, Chen L, Ferguson ND, Goligher EC, Brochard L (2020) Airway occlusion pressure as an estimate of respiratory drive and inspiratory effort during assisted ventilation. Am J Respir Crit Care Med 201:1086–1098CrossRefPubMed

23.

Hashimoto H, Yoshida T, Firstiogusran AMF, Taenaka H, Nukiwa R, Koyama Y, Uchiyama A, Fujino Y (2023) Asynchrony injures lung and diaphragm in acute respiratory distress syndrome. Crit Care Med 51:e234–e242CrossRefPubMed

24.

Parfait M, Rohrs E, Joussellin V, Mayaux J, Decavèle M, Reynolds S, Similowski T, Demoule A, Dres M (2023) An initial investigation of diaphragm neurostimulation in patients with acute respiratory distress syndrome. Anesthesiology 140(3):483–494CrossRef

25.

Yoshida T, Engelberts D, Chen H, Li X, Katira BH, Otulakowski G, Fujino Y (2022) Prone position minimizes the exacerbation of effort-dependent lung injury: exploring the mechanism in pigs and evaluating injury in rabbits. Anesthesiology 136:779–791CrossRefPubMed

Title: Bedside-available strategies to minimise P-SILI and VILI during ARDS
Authors: Oriol Roca
Irene Telias
Domenico L. Grieco
Publication date: 18-03-2024
Publisher: Springer Berlin Heidelberg
Keyword: Acute Respiratory Distress-Syndrome
Published in: Intensive Care Medicine / Issue 4/2024
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-024-07366-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Bedside-available strategies to minimise P-SILI and VILI during ARDS

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 4/2024

Learning from our unit’s first exorcism

Invasive Fungal Diseases in Adult Patients in Intensive Care Unit (FUNDICU): 2024 consensus definitions from ESGCIP, EFISG, ESICM, ECMM, MSGERC, ISAC, and ISHAM

Hypotension during intensive care stay and mortality and morbidity: a systematic review and meta-analysis

British societies guideline on the management of emergencies in implantable left ventricular assist device recipients in transplant centres

Caring for frail patients in the ICU: a multidimensional approach

Challenges for implementation of severe CAP guidelines